Suitcases from a State Hospital Attic

Introduction

It isn't often that we are able to get a glimpse into the intimate lives of people who lived in the past, and the mores of the society in which they lived. It is rarer that such an experience has the potential to move us to take action in our own present circumstances.

This afternoon, some of us in the congregation will be making a trip to the Exploratorium in San Francisco to view, among the many wonderful and exciting offerings there, an exhibit entitled "The Changing Face of Mental Illness." This exhibit has been created using the suitcases and trunks of former patients that were left behind in a psychiatric institution, Willard State Hospital in New York when it closed in 1995 after 126 years of operation. These suitcases are also the subject of a book by Darby Penney and Peter Stastny, The Lives They Left Behind - Suitcases from a State Hospital Attic published in 2008 (Bellevue Literary Press). The book tells stories of a few of the patients whose suitcases were found by researchers after the hospital closed.

Stories

Human beings resonate with stories. There is something about hearing and seeing the story that can deeply engage our imagination and conscience. To me, knowing the stories of people's experience is an important way to connect with the reality of people with mental illness in the recent past - what they went through, what the society of their time did to them. It lets me consider what we do now, and consider whether I want to accept that a society that I live in has these practices. If I can't accept it, stories will motivate me to take action. People with mental illness can be especially vulnerable. So I have found that I need to be especially careful to listen to their stories and help protect them from mistreatment. They need to know that someone sees the divine spark of humanity living within them.

To give you a taste for the kinds of stories that were uncovered, I'll give you brief summaries of three of them from Penney and Stastny's book. The authors started out with the contents of the suitcases, located the medical records and tried to contact friends and family members of the person who were still living, in order to try and paint as complete a picture as possible of the individual who owned the suitcase.

The first story is about Rodrigo Lagon who was sent by his Filipino family to study in the United States. He lived in cities with few minorities. In Chicago, he met and fell in love with a white girl, who eventually spurned him. Shortly afterwards, he began hearing negative and condemning voices. His land lady reported his depressed and odd behavior, and he was taken to a mental hospital, where he stayed with little treatment being offered to him. He considered himself deprived of his liberty rather than hospitalized for treatment. At some point, the voices stopped. Years later, a social worker mentioned in his chart, "The 51 years of institutionalization appears to have been a mistake as far as duration, as this man appears in perfect mental condition now." 51 years! Still he remained hospitalized, a model patient by all records, for another 13 years, until he died in 1981 at the age for 83 after 64 years in the hospital. 64 years!
The next story is about a woman named Ethel Smalls who shortly after her 40th birthday experienced a number of traumatic events. She divorced her abusive husband, 2 of her daughters died as infants, she had a miscarriage, she surgery to remove a tumor, her father died of cancer and she lost her home and most of her possessions. Who wouldn't be overwhelmed after a series of incidents like that? She was sent to a mental hospital after a falling-out with her land-lady, who said she that wouldn't get out of bed, and that she was argumentative and used vulgar language. Unable to cope, she was sent to a mental hospital where she preferred to think of herself as suffering from many physical ailments rather than accepting her various psychiatric diagnoses. She remained in the hospital for 43 years, dying at age 83. 43 years!
Finally we have a story about Margaret Dunleavy, a native of Scotland, who while trying to get her nursing license, worked in a hospital in New York, and contracted tuberculosis. After her discharge from the sanatorium, she worked as a private nurse, but was plagued by physical health problems and gossip about her relationship with her sweetheart Arthur who had been a TB patient with her. At some point after Arthur died, her doctor referred her to Willard Psychiatric Hospital, she was at a complete loss as to why she was brought there. She remained there for over 40 years, with her chart reporting that she was delusional, paranoid and hearing voices, all of which she denied. 40 years!

Implications for Today

On the face of it, it seems like these three people were left behind, like their suitcases. They were mistreated by the mental health system of the day. We can ask "Oh my God. This is outrageous! How could this have happened in our own society in only the recent past? Why didn't someone do something about it?" We can congratulate ourselves that today we have seen the light and people are not routinely warehoused for decades in hospitals away from the public view.

On the other hand, we can engage more deeply and listen to some voices from today of people who have mental illness and realize that we still have a way to go. I'll give some examples:

A large reason that these hospitals were closed down was to save money. In the 1950's and 60's there was a dramatic downsizing of state mental hospitals so that people could be treated in community settings. Unfortunately, community treatment was not adequate to handle all of the people. I maintain that a society with a conscience would do something about this. In California the Mental Health Services Act gives us access to funds to make a difference. We need to hold the administrators of the Act accountable. Hold them accountable.
Many people with mental health problems, including people who come to the mental health center where I work, live in Board and Care homes. These are homes where a number of people receive room and board and have their medications supervised, in exchange for receiving most of their disability check. Some of them are very nice. However, some are not so nice or not so safe for these vulnerable and sometime fragile people. To put vulnerable people in unsafe and unfriendly places is insupportable. Insupportable.
Treatment by today's mental health system can consist of as little as a 5 minute appointment once every 3 months to renew their psychiatric drug prescriptions. It is very common for people to have as many as 4 or 5 different psych drugs prescribed. As little as 5 minutes to look at the effects of all those drugs which might interact! The saddest cases I've seen are people who walk around in a stupor because of being over medicated, and can't do anything with their lives other than sit and stare. Unfortunately, this is not uncommon. This is not uncommon. Some people also get treatment by a therapist to talk over their lives and problems, and get insight on how to handle them, but many don't. Some of them are able to participate in programs of centers like the one that I work in, but many are not. I find this unacceptable. Unacceptable.
The rise of patient rights groups in the last 20 years has made a dent in some of these practices. They have fought for recovery based treatment, for self-determination, and basically for being treated as human beings with gifts and capabilities, just like anyone else. I'm right there with them.

A Call to Action

These observations suggest the following to me:

We need to work to ensure that community-based services are available to those who need them, and that they are adequate to help people build meaningful and purposeful lives. This means working with State and County offices so that they understand what is needed. The California Mental Health Services Act provides funding for mental health activities and we need to understand their priorities and help give them direction.
We need to make sure that board and care homes are places that nurture people and are places that they really want to live in. This involves getting involved with the County Behavioral Health Care services who supervise the Board and Care homes to be sure they understand what is happening, and that they are doing their jobs.
We need to advocate for adequate mental health treatment. Five minutes every 3 months is not adequate. This is controlled by the agencies that determine how disability money is spent. We can become a stakeholder in the process. We can also work to make sure that alternative approaches that cost a lot less are available to people who want and need them.
We need to meet, befriend, listen to and support people who have mental health problems. We need to guard their rights like we guard the rights of everyone else. We need to work with family members who are struggling to understand and cope with what has happened to their loved one. When people's and families rights are in jeopardy, we need to be willing to talk to our public officials and "tell truth to power" as they say.

Often when I speak to a congregation about mental health, I ask people to rise if they or someone they love is living with a mental illness. When I did it some years ago at Mission Peak, nearly everyone stood up. This happens everywhere I speak. I ask you to think of yourself or your loved one with mental illness and ask how you would want to have them treated by our society, and then move forward with what that initiative calls you to do.

My friends, these people are precious human beings. Seeing that divine spark in each person is what motivates me to begin and to continue this path of ministry. Safeguarding their lives and rights is a holy act. Safeguarding their lives and rights is a holy act. I invite you to be motivated as well and help make a difference.

I hope you can join us this afternoon. It should be an enlightening trip.

May it be so, amen.